Hi Prof. Rudnicka. Thanks for this great interview. I do have one question, however, as I'm a little puzzled by your approach to AGA treatment in relation to your observation that AGA occurs in waves. Firstly, I would be really interested if you could point to some evidence that AGA does indeed start and stop. Secondly, the problem as I see it is that even if AGA does happen in waves, the only way to catch the next onset is to let miniaturisation take its course - but in doing so you are inevitably having to allow some irreversible progression to occur, and surely this is never what the patient wants! For me, the obvious approach is just to stick on the DHT blocking medication permanently, particularly if the patient is not experiencing any adverse effects. Could you expand on your approach here - do you for example have a way of catching progression before significant damage is done?
Thank you for your comment. 1. How do I know about the variable course of AGA: Literature data and many years of experience. 2. There is no scientific proof about efficiency of finasteride treatment beyond 5 years and dutasteride even less. We base longer treatments on the biological mechanism of action. 3. I have seen patients in whom AGA did not progress for many years after discontinuation of dutasteride. 4. The preference of the patient is always an important factor influencing therapeutic decisions in AGA 5. I have the feeling that the future treatment of AGA may include anti inflammatory medications. In general I share your logic and there are many factors that need to be taken into consideration.
@@profLidiaRudnicka Thanks so much for the reply! Your clinical observations are very interesting. If I understand you correctly, you are suggesting that AGA may be aggravated by waves of inflammatory activity in addition to the simple presence of DHT? I absolutely share your interest in this possibility and am excited to see how the research develops. Regarding the long term efficacy of finasteride, it does seem right to point to a few sources: firstly, the research by Imperato-McGinley and Hamilton demonstrating that those with 5ar and androgen deficiencies do not develop AGA in their lifetimes. Also, Rossi et al (2011) and Yanagisawa et al (2019) confirming the 10 year efficacy of finasteride in both European and Asian populations.
Great information! I'm a Trichologist and I did a hair loss consultation with a client who appears to have FPHL I used the trichoscopy and did see yellow dots on the scalp they were bright yellow and some of the hair follicles were surrounded by a white cast but no minimization. She had the classic Christmas tree pattern. I understand that there are a couple of hair loss conditions that have some of the same characteristics as female pattern hair loss. I'm second guessing my thoughts on if FPHL is what she has or it could be Alopecia areata incognita or diffuse Alopecia areata. Because she said her hair is not as thin looking on in the crown area. This is without any treatment. FPHL wouldn't get better it would get worse. This is why I think she has something else. The bright yellow dots are mainly in the crown area and I noticed there were a few pigtail hairs and thin/gray hair that you would see if someone has AAI or DAA. I would love to hear your thoughts on this.
Im 38 years old and I have Alopecia Totallis since i was 6 years old im on treatment right now. And my son his 20 years old and have Alopecia Universalis. Hope one day you can come to Chicago and meet you one day!
Definitely! Actually, I was born in Chicago. This would be another reason to come 😊. Also, you may plan to go to Poland one day. It’s a beautiful country!
Thanks for wonderful information. What are side effects of Dutasteride for a woman? Unfortunately, spironolactone caused too much dizziness and other bad side effects.
Thank you very much for this interview. It was very informative, especially for the person like me, who is undergoing the treatment for androgenetic alopecia (combined with Telogen Effluvium).
Great video professor, thank you for your great work. I’m 41 and have slight thining around the crown, but mainly hair loss at the front on the right and left side. I guess a number “3 vertex” on the Norwood scale. My hair is very dense everywhere else currently. I know everyone is different and you can’t really say without seeing me, but would you suggest I start looking down the oral finasteride or oral minoxidil route first? I’m going to start one, but not sure which would be better in my situation. If you have any advice it would be appreciated, but I also understand that it may be difficult to advice. Either way, thanks again for the great info on your videos.
@@profLidiaRudnicka can you tell us why does it work for hirsutism and androgenic alopecia but not for hormal acne? The culprit is DHT. That is being blocked by finasteride?
@@profLidiaRudnicka can u please do a video on pcos related hair loss and its treatments. especially the difference between oral spironolactone versus oral finasteride in adrogenetic alopecia in women? and if finasteride or spironolactone affects only hair follicles or breast tissue / skin/ muscles as well? Can finasteride be used to treat acne and hirsutism as well like how spironolactone is used. Another video on lichen plano pillaris and its treatment, especially in women in their 20s. the side effects of strong steroids on scalp especially skin atrophy and systemic absorption of steroids. And use of low dose doxycyline as anti inflammatory.
@@Stopbruhpls Thanks a lot for all suggestions. I look forward to receiving new ideas! Regarding PCO, I leave it to the endocrinologists. For all other topics I will be happy to work on the videos.
Dear Doctor, I have been looking for ways to conduct a consultation with you. However, I have trouble to find a contact number. If you could provide me with one, I would very much appreciate it. Regards, Murad
Wonderful interview. Very informative. Thank you both.
Thank you!
thank you both for this interview! it was very informative. would also love if Professor discussed use of androgen and 5AR inhibitors in women.
@@stephaniemaggotta4226 Thank you. Yes, this is an important topic. I will work on it! Thanks for the suggestion !
@@profLidiaRudnicka i am looking forward to it!
Dziękuję bardzo Pani Profesor
When would you switch to dutasteride?
Hi Prof. Rudnicka. Thanks for this great interview. I do have one question, however, as I'm a little puzzled by your approach to AGA treatment in relation to your observation that AGA occurs in waves. Firstly, I would be really interested if you could point to some evidence that AGA does indeed start and stop. Secondly, the problem as I see it is that even if AGA does happen in waves, the only way to catch the next onset is to let miniaturisation take its course - but in doing so you are inevitably having to allow some irreversible progression to occur, and surely this is never what the patient wants! For me, the obvious approach is just to stick on the DHT blocking medication permanently, particularly if the patient is not experiencing any adverse effects. Could you expand on your approach here - do you for example have a way of catching progression before significant damage is done?
Thank you for your comment.
1. How do I know about the variable course of AGA: Literature data and many years of experience.
2. There is no scientific proof about efficiency of finasteride treatment beyond 5 years and dutasteride even less. We base longer treatments on the biological mechanism of action.
3. I have seen patients in whom AGA did not progress for many years after discontinuation of dutasteride.
4. The preference of the patient is always an important factor influencing therapeutic decisions in AGA
5. I have the feeling that the future treatment of AGA may include anti inflammatory medications.
In general I share your logic and there are many factors that need to be taken into consideration.
@@profLidiaRudnicka Thanks so much for the reply! Your clinical observations are very interesting. If I understand you correctly, you are suggesting that AGA may be aggravated by waves of inflammatory activity in addition to the simple presence of DHT? I absolutely share your interest in this possibility and am excited to see how the research develops.
Regarding the long term efficacy of finasteride, it does seem right to point to a few sources: firstly, the research by Imperato-McGinley and Hamilton demonstrating that those with 5ar and androgen deficiencies do not develop AGA in their lifetimes. Also, Rossi et al (2011) and Yanagisawa et al (2019) confirming the 10 year efficacy of finasteride in both European and Asian populations.
Thank you professor, this was very insightful!
Thanks a lot :-)
Great information! I'm a Trichologist and I did a hair loss consultation with a client who appears to have FPHL I used the trichoscopy and did see yellow dots on the scalp they were bright yellow and some of the hair follicles were surrounded by a white cast but no minimization. She had the classic Christmas tree pattern. I understand that there are a couple of hair loss conditions that have some of the same characteristics as female pattern hair loss. I'm second guessing my thoughts on if FPHL is what she has or it could be Alopecia areata incognita or diffuse Alopecia areata. Because she said her hair is not as thin looking on in the crown area. This is without any treatment. FPHL wouldn't get better it would get worse. This is why I think she has something else. The bright yellow dots are mainly in the crown area and I noticed there were a few pigtail hairs and thin/gray hair that you would see if someone has AAI or DAA. I would love to hear your thoughts on this.
I am sorry, it is not possible to consult individual cases via RUclips. Thank you for your comment!
Im 38 years old and I have Alopecia Totallis since i was 6 years old im on treatment right now. And my son his 20 years old and have Alopecia Universalis. Hope one day you can come to Chicago and meet you one day!
Definitely! Actually, I was born in Chicago. This would be another reason to come 😊. Also, you may plan to go to Poland one day. It’s a beautiful country!
Thanks for wonderful information. What are side effects of Dutasteride for a woman? Unfortunately, spironolactone caused too much dizziness and other bad side effects.
For androgenetic alopecia in women dutasteride is an option
Thank you very much for this interview.
It was very informative, especially for the person like me, who is undergoing the treatment for androgenetic alopecia (combined with Telogen Effluvium).
Thanks a lot for your feedback
Great video professor, thank you for your great work. I’m 41 and have slight thining around the crown, but mainly hair loss at the front on the right and left side. I guess a number “3 vertex” on the Norwood scale. My hair is very dense everywhere else currently. I know everyone is different and you can’t really say without seeing me, but would you suggest I start looking down the oral finasteride or oral minoxidil route first? I’m going to start one, but not sure which would be better in my situation. If you have any advice it would be appreciated, but I also understand that it may be difficult to advice. Either way, thanks again for the great info on your videos.
Thank you for your understandin! 💕
GREAT THANKS......HOPE TO MEET YOU SOON IN EGYPT.....GOOD LUCK BEST WISHES
I hope so too! Thank you very much!
Thank you for the video
@@nicolaslorenzo78 Thanks a lot 🙂
Does finasteride also help with acne and hirsutism like how spironolactone does ? Or does it ONLY helps hair loss?
Finasteride has some documented efficacy in hirsutism. It is not used for acne.
@@profLidiaRudnicka can you tell us why does it work for hirsutism and androgenic alopecia but not for hormal acne? The culprit is DHT. That is being blocked by finasteride?
can you do a video of androgenetic alopecia in WOMEN. Also on scarring alopecia in WOMEN
Sure. Anything specific ?
@@profLidiaRudnicka can u please do a video on pcos related hair loss and its treatments. especially the difference between oral spironolactone versus oral finasteride in adrogenetic alopecia in women? and if finasteride or spironolactone affects only hair follicles or breast tissue / skin/ muscles as well? Can finasteride be used to treat acne and hirsutism as well like how spironolactone is used.
Another video on lichen plano pillaris and its treatment, especially in women in their 20s. the side effects of strong steroids on scalp especially skin atrophy and systemic absorption of steroids. And use of low dose doxycyline as anti inflammatory.
@@Stopbruhpls Thanks a lot for all suggestions. I look forward to receiving new ideas! Regarding PCO, I leave it to the endocrinologists. For all other topics I will be happy to work on the videos.
@@profLidiaRudnicka I will look forward to all of these videos. i love how you go in depth and tiny details.
@@profLidiaRudnicka CCCA
Actually minoxidil was originally used not for blood pressure but to treat ulcers.
Thank you. Can I please ask you for a reference?
Dear Doctor,
I have been looking for ways to conduct a consultation with you. However, I have trouble to find a contact number. If you could provide me with one, I would very much appreciate it.
Regards,
Murad
dermatolodzy.com.pl/home/